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Department of Complementary Medicine, School of Postgraduate Medicine and Health Sciences, University of Exeter, Exeter EX2 4NT

EDITOR—In their review of acupuncture, Vickers and Zollman1 state that systemic infection seems to be uncommon. When it occurs, however, it can be devastating, and the single reported fatality from acupuncture last year was due to streptococcal toxic shock-like syndrome.2 A 41 year old man who received acupuncture for shoulder pain collapsed three days later with rapidly spreading erythematous and necrotic change in the skin of the shoulder. Despite immediate extensive debridement and high doses of …

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